This lab value is the elephant in the room, this is causing your problems. You need more testosterone to increase estrogen.
This estrogen level would cause misery for most men including fatigue, ED, low libido and moodiness just off the top of my head.
Natural men not on TRT get estrogen from aromatase and also created inside the testicles. If you’ve lost aromatase enzymes that could be why estrogen is low.
You probably need TRT to correct low estrogen and prevent/treat osteoporosis. I wouldn’t be surprised if your doctor diagnosed you with osteoporosis tomorrow.
Now you just need to find a doctor that knows what the h*** he’s doing, one that knows hormones well because the average doctor isn’t going to be concerned with the low estrogen value do to a lack of knowledge which is very common in this day and age.
A mistake a lot of people make is believing in range is healthy, for an 8 year old sure, but not a grown man past puberty.